BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) form translates patient treatment preferences into medical orders. The Oregon POLST Registry provides emergency personnel 24-h access to POLST forms. OBJECTIVE: To determine if Emergency Medical Technicians (EMTs) can use the Oregon POLST Registry to honor patient preferences. METHODS: Two telephone surveys were developed: one for the EMT who made a call to the Registry and one for the patient or the surrogate. The EMT survey was designed to determine if the POLST form accessed through the Registry changed the care of the patient. The patient/surrogate survey was designed to determine if the care provided matched the preferences on the POLST. When feasible, the Emergency Medical Services (EMS) record was reviewed to determine whether or not treatment was provided. RESULTS: During the study period there were 34 EMS calls with matches to patients' POLST forms, and 23 interviews were completed with EMS callers, for a response rate of 68%. In seven cases (30%) the patient was in cardiopulmonary arrest; one patient had a respiratory arrest with a pulse. Eight respondents (35%) reported that the patient was conscious and apparently able to make decisions about preferences. For 10 cases (44%) the POLST orders changed treatment, and in six instances (26%) they affected the decision to transport the patient. For the 10/11 patients or surrogates interviewed, the care reportedly matched their wishes. CONCLUSION: This small study suggests that an electronic registry of POLST forms can be used by EMTs to enhance their ability to locate and honor patient preferences regarding life-sustaining treatments.
BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) form translates patient treatment preferences into medical orders. The Oregon POLST Registry provides emergency personnel 24-h access to POLST forms. OBJECTIVE: To determine if Emergency Medical Technicians (EMTs) can use the Oregon POLST Registry to honor patient preferences. METHODS: Two telephone surveys were developed: one for the EMT who made a call to the Registry and one for the patient or the surrogate. The EMT survey was designed to determine if the POLST form accessed through the Registry changed the care of the patient. The patient/surrogate survey was designed to determine if the care provided matched the preferences on the POLST. When feasible, the Emergency Medical Services (EMS) record was reviewed to determine whether or not treatment was provided. RESULTS: During the study period there were 34 EMS calls with matches to patients' POLST forms, and 23 interviews were completed with EMS callers, for a response rate of 68%. In seven cases (30%) the patient was in cardiopulmonary arrest; one patient had a respiratory arrest with a pulse. Eight respondents (35%) reported that the patient was conscious and apparently able to make decisions about preferences. For 10 cases (44%) the POLST orders changed treatment, and in six instances (26%) they affected the decision to transport the patient. For the 10/11 patients or surrogates interviewed, the care reportedly matched their wishes. CONCLUSION: This small study suggests that an electronic registry of POLST forms can be used by EMTs to enhance their ability to locate and honor patient preferences regarding life-sustaining treatments.
Authors: Cari Levy; Mary Ersek; Winifred Scott; Joan G Carpenter; Jennifer Kononowech; Ciaran Phibbs; Jill Lowry; Jennifer Cohen; Marybeth Foglia Journal: J Gen Intern Med Date: 2020-02-24 Impact factor: 5.128
Authors: Dana M Zive; Jennifer Cook; Charissa Yang; David Sibell; Susan W Tolle; Michael Lieberman Journal: J Med Syst Date: 2016-10-01 Impact factor: 4.460
Authors: Susan E Hickman; Alexia M Torke; Greg A Sachs; Rebecca L Sudore; Qing Tang; Giorgos Bakoyannis; Nicholette Heim Smith; Anne L Myers; Bernard J Hammes Journal: J Am Geriatr Soc Date: 2021-03-24 Impact factor: 7.538
Authors: Susan E Hickman; Alexia M Torke; Greg A Sachs; Rebecca L Sudore; Qing Tang; Giorgos Bakoyannis; Nicholette Heim Smith; Anne L Myers; Bernard J Hammes Journal: J Gen Intern Med Date: 2020-10-27 Impact factor: 5.128